Organization
LETCHER VOLUNTARY FIRE AND RESCUE SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN GILLEY (CHIEF EXECUTIVE OFFICER)
(606) 633-8058
Entity
Organization
Contact information
Practice address
2429 HWY 7 SOUTH, JEREMIAH, KY 41826-9082
(606) 633-8058
Mailing address
PO BOX 89, JEREMIAH, KY 41826-0089
(606) 633-8058
(304) 522-4222
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1503
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000070207
ANTHEM
KY
01
—
080658200
BLACK LUNG
KY
05
—
55067060
—
KY
05
—
56008055
—
KY
01
—
590009888
RAILROAD MEDICARE
KY
Enumeration date
07/13/2005
Last updated
04/21/2023
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